Dr. Barry Ramo

The year 2020 will go down as a terrible year for heart disease.
Weight gain, prolonged sitting and unhealthy food choices top the list of co-conspirators harming heart health.
When cardiac symptoms come, people are ignoring them, so more people are dying at home or delaying care. They fail to receive therapy like a stent and are left with major heart damage.
Make 2021 a time to be good to your heart. Know your numbers: weight, waist size, cholesterol, blood sugar, blood pressure and CRP, a marker of inflammation.
Two objective tests for obesity are body mass index (BMI) and waist size.
BMI is the ratio between your height and weight. Normal BMI is 19-26; you are obese if you are more than 30.
Your waist size is a better predictor of atherosclerotic cardiovascular disease (ASCVD).
Fat that makes a protuberant abdomen (pot belly) is dangerous, whereas generous hips (pear shape) are not.
Your waist should be less than 40 inches around for men, and less than 35 for women.
A big belly results from fat around your organs. This fat causes inflammation and insulin resistance, predisposing you to diabetes.
Central obesity is also linked to hypertension and sleep apnea. Serious weight loss will reduce the risks from central obesity.
Three blood tests — a lipid panel, A1C and CRP — are important. The lipid panel reports cholesterol numbers: HDL (H for happy), LDL (L for lousy) and triglycerides.
Attack high LDL with diet, exercise and sometimes medication.
The American Heart Association/American College of Cardiology provides a risk score indicating your 10-year risk for developing ASCVD symptoms such as a heart attack, stroke or death from cardiovascular disease. If you are under 60, it reports your lifetime risk.
That score will help guide you and your doctor on treatment.
When the score is intermediate, a coronary artery calcium study that reveals evidence of ASCVD can determine if you need medication to lower LDL cholesterol. Triglycerides are usually dealt with through diet and weight loss.
A1C measures your average blood sugar during the previous two to three months and tells your risk for diabetes or if you already have it. If you are prediabetic, losing about 10 percent of your body weight can bring you into a normal range.
The CRP number is a marker of inflammation and increases with central obesity. In recent years, we have learned inflammation is a major factor in ASCVD, and reducing it reduces risks.
High blood pressure is a silent killer. You may not know you have it until you have a stroke or heart attack.
Recording your blood pressure after sitting for five minutes in a quiet room is a far better way to diagnose and treat hypertension than measurements taken elsewhere. It’s also a better predictor of future ASCVD events.
You can get a good blood pressure cuff for less than $50.
Take a measure of your diet: I encourage heart-disease patients to follow a Mediterranean type of diet — a plant-based diet has been linked to lower risk for ASCVD, hypertension and diabetes — and very effective for weight management.
COVID-19 has meant a huge increase in the time we are sitting; sitting time is a risk factor for ASCVD. Numerous reports indicate you derive the greatest cardiovascular benefit from just walking 15-30 minutes a day and not sitting.
Buy an inexpensive pedometer, record your steps and try to get at least 5,000 steps and work up if you can.
Check our website at New Heart Fitness and Health for exercises you can do at home using your body weight and bands.
Let’s make 2021 a good year for your heart.

(Dr. Barry Romo is the medical director at New Heart Fitness and Health, and a cardiologist with New Mexico Heart Institute/Lovelace Medical Group.)See